UK Trainee (resident) looking to settle in USA

[Cross clamp]

Hi

Need some help guys. I am sure questions along this line have been asked before but not in specific detail.

I am a UK trainee in cardiac surgery. I have my USMLE's. I would like to move to the USA and obtain an attending post.
I am in the process to obtain a fellowship in the USA to gain higher skills in cardiac transplantation.

I have seen in certain centres they have attendings /assistant professors who have completed their training outside the USA, and are now working in the USA

I would be very grateful for any advice and guidance how I might be able to settle in the USA work in my specialty without having to re train all over again.

Best Wishes

cross clamp

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[ThoracicGuy]

Hi

Need some help guys. I am sure questions along this line have been asked before but not in specific detail.

I am a UK trainee in cardiac surgery. I have my USMLE's. I would like to move to the USA and obtain an attending post.
I am in the process to obtain a fellowship in the USA to gain higher skills in cardiac transplantation.

I have seen in certain centres they have attendings /assistant professors who have completed their training outside the USA, and are now working in the USA

I would be very grateful for any advice and guidance how I might be able to settle in the USA work in my specialty without having to re train all over again.

Best Wishes

cross clamp

Without three years of US based residency training you are not eligible for a permanent license. You are then stuck on a sponsored license by an academic institution. That license is not transferrable.

 

[Surgeria]

Without three years of US based residency training you are not eligible for a permanent license. You are then stuck on a sponsored license by an academic institution. That license is not transferrable.

3 years of fellowship after a residency training abroad, can this be considered as a 3 year US based residency? I also have seen many attendings in USA according to the web sites (especially in cardiac surgery) that were trained abroad. I am not sure but there is some hint, something like "thoracic surgery board exam has no prerequisite of 5 year general surgery training", but for example a pediatric surgery board exam I guess has that prerequisite. I saw ortho, ent, neurosurgery attendings with a surgical training abroad. How does that people sat for the board exams? Even though how does that people afterwards obtain an attending position if they are not citizens? - I am pretty sure that you can not do that on J1 because there would probably be no spots for cardiac surgery J1 waiver. So the only option is to get an a fellowship on H1B, then somehow take the board exam ( have no idea how), and then find a job on H1B and afterwards switch to green card.

 

[ThoracicGuy]

3 years of fellowship after a residency training abroad, can this be considered as a 3 year US based residency? I also have seen many attendings in USA according to the web sites (especially in cardiac surgery) that were trained abroad. I am not sure but there is some hint, something like "thoracic surgery board exam has no prerequisite of 5 year general surgery training", but for example a pediatric surgery board exam I guess has that prerequisite. I saw ortho, ent, neurosurgery attendings with a surgical training abroad. How does that people sat for the board exams? Even though how does that people afterwards obtain an attending position if they are not citizens? - I am pretty sure that you can not do that on J1 because there would probably be no spots for cardiac surgery J1 waiver. So the only option is to get an a fellowship on H1B, then somehow take the board exam ( have no idea how), and then find a job on H1B and afterwards switch to green card.

Here's the link to board certification pathways currently available:

Pathways to Certification

There are no pathways that include foreign training (unless you would consider Canada foreign). So these people you see are not board certified. They can do 3 years of US training and get a permanent license, but that's it.

The best path to practice CT surgery in the US for a FMG is to do general surgery training in the US followed by a CT fellowship.

 

[Surgeria]

Here's the link to board certification pathways currently available:

Pathways to Certification

There are no pathways that include foreign training (unless you would consider Canada foreign). So these people you see are not board certified. They can do 3 years of US training and get a permanent license, but that's it.

The best path to practice CT surgery in the US for a FMG is to do general surgery training in the US followed by a CT fellowship.

Thank you very much for an answer, I appreciate it. I am not sure about the differences between the board certification and having a permanent licence. Does the permanent licence let someone to work in any hospital in USA, or is it attached to a particular hospital? And how looks like the process of getting this kind of permanent licence after 3 years of fellowship? Is this very much personal thing and depends on the relationship between the fellow and the let's say chairman of CT surgery (If he wishes so, then you can apply and sit for the exam), or any fellow has a right to sit for licence exam after 3 years? (Considering that he/she is ECFMG certified + passed USMLE step 3).

I agree with you about general surgery + CT fellowship, but you know better than me how things are going for FMG's nowadays. This pathway looks even more realistic for me than going through the classical pathway of gen surg+CT which I of course will try and do my best, but if something goes wrong the fellowship + permanent licence sounds great, but who knows what will change in 10 years, maybe that door will also close.

 

[ThoracicGuy]

Thank you very much for an answer, I appreciate it. I am not sure about the differences between the board certification and having a permanent licence. Does the permanent licence let someone to work in any hospital in USA, or is it attached to a particular hospital? And how looks like the process of getting this kind of permanent licence after 3 years of fellowship? Is this very much personal thing and depends on the relationship between the fellow and the let's say chairman of CT surgery (If he wishes so, then you can apply and sit for the exam), or any fellow has a right to sit for licence exam after 3 years? (Considering that he/she is ECFMG certified + passed USMLE step 3).

I agree with you about general surgery + CT fellowship, but you know better than me how things are going for FMG's nowadays. This pathway looks even more realistic for me than going through the classical pathway of gen surg+CT which I of course will try and do my best, but if something goes wrong the fellowship + permanent licence sounds great, but who knows what will change in 10 years, maybe that door will also close.

A permanent license is required to practice independent medicine in the US. Board certification is not required, but many insurance plans will require it to be eligible to accept that plan. An unrestricted permanent license would allow you to work anywhere that will hire you. Now when you see foreign practioners on hospital websites that don't have permanent licenses, they can have a restricted license that is generally tied to a specific institution. If they are fired or leave that job, they lose their license.

In the US for a FMG, you generally need 3 years of US based training to be eligible. Then all you would need is to have passed all of the USMLE step exams.

As for board certification, you have to qualify per the individual boards. For CT surgery, without having the US training as set forth in the link I gave in the prior message, you would not be able to be board certified. You can't have a chairman bypass the rules to gain it. You would then generally be limited in your job opportunities due to not being able to accept many of the insurances.

If you want to practice in the US, you should really only look towards getting US training. Foreign trainees are at a disadvantage at getting fellowship spots as well as the programs are rated based on trainees that go on to get board certification, which you wouldn't be eligible for.

 

[Surgeria]

A permanent license is required to practice independent medicine in the US. Board certification is not required, but many insurance plans will require it to be eligible to accept that plan. An unrestricted permanent license would allow you to work anywhere that will hire you. Now when you see foreign practioners on hospital websites that don't have permanent licenses, they can have a restricted license that is generally tied to a specific institution. If they are fired or leave that job, they lose their license.

In the US for a FMG, you generally need 3 years of US based training to be eligible. Then all you would need is to have passed all of the USMLE step exams.

As for board certification, you have to qualify per the individual boards. For CT surgery, without having the US training as set forth in the link I gave in the prior message, you would not be able to be board certified. You can't have a chairman bypass the rules to gain it. You would then generally be limited in your job opportunities due to not being able to accept many of the insurances.

If you want to practice in the US, you should really only look towards getting US training. Foreign trainees are at a disadvantage at getting fellowship spots as well as the programs are rated based on trainees that go on to get board certification, which you wouldn't be eligible for.

Thank you for such a thorough answer, your input is invaluable because this kind of information is not on the web. I have one more question if you don't mind. When you mentioned 3 years of US based training, what do you mean by that? 3 years of ACGME accredited training or it can be 3 years of non-ACGME accredited training. How looks like the process, do the fellows apply through ERAS or do they arrange this spots directly with departments and get them kind of out of the match? Thank you.